652 Balantidium Coli 



some action upon all varieties of the organism, exert a much more 

 powerful influence upon the particular variety used in their prepa- 

 ration. The same is true of the patient's serum, hence, in making 

 use of the agglutination reaction for the diagnosis of the disease, 

 the blood of the patient should be tested by contact with all of 

 the different cultures. 



Serum Therapy. By the progressive immunization of horses 

 to an immunizing fluid, the basis of which is a twenty-four-hour- 

 old agar-agar culture dried in vacua, Shiga prepared an antitoxic 

 serum with which, in 1898, in the Laboratory Hospital 65 cases 

 were treated, with a death-rate of 9 per cent.; in 1899, in the Labo- 

 ratory Hospital, 91 cases, with a death-rate of 8 per cent.; in 1899, 

 in the Hirowo Hospital, no cases, with a death-rate of 12 per 

 cent. These results are very significant, as the death-rate in 

 2736 cases simultaneously treated without the serum averaged 

 34.7 per cent., and in consideration of the frequency and high death- 

 rate of the disease, Japan alone, between the years 1878 and 1899, 

 furnishing a total of 1,136,096 cases, with 275,308 deaths (a total 

 mortality for the entire period of 24.23 per cent.).* 



BALANTZDIUM DIARRHEA 



BALANTIDIUM COLI (MALMSTEN) 



In certain rare cases a severe form of diarrhea, or a mild form of dysentery 

 appears to depend neither upon Entamoeba histolytica nor Bacillus dysenteriae, 

 but upon an infusorian parasite known as Balantidium coli. This organism was 

 first observed by Malmstenf in 1857 in the intestines of a man who had suffered 

 from cholera two years before and had ever since suffered from diarrhea. Upon 

 investigation, an ulceration was found in the rectum just above the internal 

 sphincter. In the bloody pus from this ulcer numerous balantidia were seen 

 swimming about. Although the ulcer healed, the diarrhea did not cease. Since 

 this original observation and up to igo8,Brauni had beenableto collect 142 cases 

 of human infection. In all of these N cases the presence of the balantidium was 

 accompanied by obstinate diarrhea with bloody discharges (dysentery) in some, 

 and many of the cases ended in death. 



Morphology. 'The Balantidium coli is a ciliate protozoan micro-organism of 

 ovoid or ellipsoidal form, measuring from 30 to 200 p in length and from 20 to 

 70 ju in breadth. The body is surrounded by a distinct ectosarc completely 

 covered by short fine cilia. The anterior end, which is usually a little sharper 

 than the posterior, presents a deep indentation, the peristome, which continues, 

 in an infundibuliform manner, deeply into the endosarc. The peristome is 

 surrounded by a circle of longer cilia adoral cilia than those elsewhere upon 

 the body. At the opposite pole there is a small opening in the ectosarc, the 

 anus. The mouth is the simple termination of the infundibuliform extension of 

 the peristome and opens directly into the endosarc, so that the small bodies upon 

 which the organism feeds, and which are continually being caught in the vortex 

 caused by the rapidly vibrating adoral cilia are driven down the short tubulature 

 directly into the endosarc. 



The endosarc is granular and contains fat and mucin granules, starch grains, 

 bacteria, and occasionally red and white blood-corpuscles. 



There are usually two contractile vacuoles, sometimes more, and as the quiet 



* "Public Health Reports," Jan. 5, 1900, vol. xv, No. i. 



f " Archiv. f. pathologische Anatomie," etc., xn, 1857, p. 302. 



j "Tierische Parasiten des Menschen," Wurzburg, 1908. 



